Alanine aminotransferase-aspartate aminotransferase ratio is the best surrogate marker for insulin resistance in non-obese Japanese adults

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Cardiovascular Diabetology

, 11:117

First Online: 01 October 2012Received: 09 August 2012Accepted: 20 September 2012

Abstract

BackgroundThe aim of the present study was to examine how liver markers are associated with insulin resistance in Japanese community-dwelling adults.

ResultsIn non-obese subjects, the best marker of insulin resistance was alanine aminotransferase ALT-aspartate aminotransferase AST ratio of 0.70 95% confidence interval CI, 0.63-0.77. In overweight subjects, AUC values for the ALT-AST ratio and ALT were 0.66 0.59-0.72 and 0.66 0.59-0.72, respectively. Multiple linear regression analyses for HOMA-IR showed that ALT-AST ratios were independently and significantly associated with HOMA-IR as well as other confounding factors in both non-obese and overweight subjects. The optimal cut-off point to identifying insulin resistance for these markers yielded the following values: ALT-AST ratio of ≥0.82 in non-obese subjects and ≥1.02 in overweight subjects. In non-obese subjects, the positive likelihood ratio was greatest for ALT-AST ratio.

ConclusionsIn non-obese Japanese adults, ALT-AST ratio may be the best reliable marker of insulin resistance.

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